Individual
DENNIS WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1366 S RIVERSIDE AVE, RIALTO, CA 92376
(909) 421-2020
(909) 285-9586
Mailing address
1366 S RIVERSIDE AVE, RIALTO, CA 92376-7608
(909) 421-2020
(909) 990-1560
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13292
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245438365
—
CA
Enumeration date
07/10/2007
Last updated
01/24/2020
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